Claims Examiner II - Litigation Unit
- Employer
- Topa Insurance Group
- Location
- Calabasas, California
- Salary
- $80,000 to $90,000 Annually - 401K, Dental, Life, Medical, Vision
- Posted
- May 16, 2018
- Closes
- Jul 15, 2018
- Category
- Claims, Legal / Compliance
- Job Type
- Full Time
- Career Level
- Experienced (Non-Manager)
Primarily responsible for the complete handling, including establishing of coverage, liability and damages, to enable equitable resolutions of all claims assignments. Undertake responsibility for complex and / or high exposure claim assignments in all lines.
Essential job functions include:
- Responsible for investigation, analysis and evaluation of all claim assignments to include the issues of coverage, liability and damages.
- Negotiates equitable settlements and produce successful resolutions in accordance with company policies and department guidelines.
- Exercise independent judgement and employs sound decision making in undertaking the above responsibilities.
- Comply with all aspects of the Fair Claims Settlement Practices Regulations.
- Properly document all claim files with dated progress notes and reports to record results of investigation and handling, stating reasons for decisions and evaluations in accordance with guidelines.
- Establish and maintain appropriate reserves on all claims that reflect company policies and guidelines.
- Attend settlement conferences, other meetings and hearings as required.
- Assist in reaching company and department objectives by reducing pending files and successfully concluding all claim assignments, maintains 100% closing ratio.
- Undertake responsibility for re-insurance reporting.
- Analyze and evaluate converge issues and prepare communication on coverage positions.
- Analyze and evaluate complex claim issues and high exposure claims with plans for implementing resolutions and conducting the activity to reach resolution
- Conduct study and research in related claims areas as may be requested by Claims Management.
Job Qualifications:
- 10 years of claims experience
- Litigation management
- Coverage analysis
- Experience with Commercial transportation, excess liability and complex litigation
- Construction defect experience preferred
- Ability to do overnight travel for mediations and conferences
- BA, professional designation - required.